摘要
目的探讨选择不同微通道内镜手术方式治疗输尿管上段复杂结石的特点及临床治疗效果。方法采取回顾性分析手法,以我院泌尿外科的病人为研究对象,通过对接受了逆行输尿管镜(URL)、微创经皮肾镜碎石术(MPCNL)以及后腹腔镜输尿管切开取石术(RLU)的患者,进行观察和追踪,通过其临床效果,恢复情况来比较3种治疗方法的成功率、碎石清除率及并发症。结果 101例患者中,URL治疗21例,1次手术成功者19例,2例患者在行输尿管镜插管时,无法到达结石部位,术后1月结石清除率为85.0%,并发症发生率为9.0%。MPCNL治疗60例,全部1次手术成功,结石清除率为100.0%,无并发症。RLU治疗20例,1次手术成功率为100%,结石1次取尽,无并发症。术后随访75例,随访时间1至2年,无复发。结论 3种微创手术方式的疗效都是确切而值得肯定的。但是各有优缺点,应根据患者临床需求及医院实际情况选择治疗方案。
Objective To evaluate the therapeutic effect of different access tracts of endoscopic surgery in the treatment of complicated stone of the upside of ureter. Methods A retrospective analysis was conducted among 101 patients undergoing minimally invasive percutaneous nephrolithotomy （MPCNL）, retroperitoneal laparoscopic ureterolithotomy （RLU） and retrograde ureteroscope for treatment of complex stones of the upside of ureter. The success rate, complications and stone clearance rate were compared in three techniques. Results Of these 101 cases,21 were received retrograde ureteroscope in whom 19 were completed in success in one time and the stone clearance rate and complications were 85% and 9%. 60 cases and 20 cases underwent MPCNL and RLU. Both the success rates were 100% and no complications occurred in all of the patients. No stone recurrence was found in the follow-up of 12 to 24 months. Conclusion The three of minimally invasive surgical approaches have access to good effect, but have their own advantages and disadvantages. The treatment options should be based on the actual situation of the clinical needs of patients and hospitals.
出处
《岭南现代临床外科》
2012年第3期228-230,共3页
Lingnan Modern Clinics in Surgery
关键词
输尿管上段复杂结石
逆行输尿管镜
经皮肾镜碎石术
后腹腔镜输尿管切开取石术
Complicated stone of the upside of ureter
Retrograde ureteroscopy
Percutaneous nephrolithotomy
Retroperitoneal laparoscopie ureterolithotomy
